2026-01-01 COI GL PL.pdf
PDF 97 KB Posted
- Attached to
- Master Agreement AZ|CTR076390
- Contract number
- CTR076390
- Issued by
- Arizona
About this file
This document is an ACORD Certificate of Liability Insurance for Mayo Collaborative Services, Inc. (doing business as Mayo Clinic Laboratories), issued on February 13, 2025. The certificate names the Arizona Department of Health Services in Phoenix, AZ as the certificate holder, with coverage provided by Mayo Insurance Company Limited.
The insurance certificate covers professional liability with policy limits of $2,000,000 per claim and $4,000,000 aggregate, effective from January 1, 2025 to January 1, 2026. The policy includes the State of Arizona, its departments, agencies, boards, commissions, universities, officers, officials, and employees as additional insureds with respect to liability arising from activities performed by or on behalf of the insured. The policy also includes commercial general liability coverage with a $1,000,000 each occurrence limit and various standard aggregate limits.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| CTR075690_Pricing.xlsx | XLSX spreadsheet | |
| 2026-01-01 COI WC.pdf | ||
| CTR075690_Contract_Documents.pdf | ||
| CTR076390_Amendment_One__1__fully_executed.pdf |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
INSURER(S) AFFORDING COVERAGE
INSURER F :
INSURER E :
INSURER D :
INSURER C :
INSURER B :
INSURER A :
NAIC #
NAME:
CONTACT
(A/C, No):
FAX
ADDRESS:
PRODUCER
(A/C, No, Ext):
PHONE
INSURED
REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
OTHER:
(Per accident)
(Ea accident)
N / A
SUBR
WVD
ADDL
INSD
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
$PROPERTY DAMAGE
BODILY INJURY (Per accident)
BODILY INJURY (Per person)
COMBINED SINGLE LIMIT
AUTOS ONLY
AUTOSAUTOS ONLY
NON-OWNED
SCHEDULEDOWNED
ANY AUTO
AUTOMOBILE LIABILITY
Y / N
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
DESCRIPTION OF OPERATIONS below If yes, describe under
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. DISEASE - POLICY LIMIT
E.L. DISEASE - EA EMPLOYEE
E.L. EACH ACCIDENT
ER
OTH-
STATUTE
PER
LIMITS(MM/DD/YYYY)
POLICY EXP
(MM/DD/YYYY)
POLICY EFF
POLICY NUMBERTYPE OF INSURANCELTR
INSR
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
EXCESS LIAB
UMBRELLA LIAB $EACH OCCURRENCE
$AGGREGATE
OCCUR
CLAIMS-MADE
DED RETENTION $
$PRODUCTS - COMP/OP AGG
$GENERAL AGGREGATE
$PERSONAL & ADV INJURY
$MED EXP (Any one person)
$EACH OCCURRENCE
DAMAGE TO RENTED
$PREMISES (Ea occurrence)
COMMERCIAL GENERAL LIABILITY
CLAIMS-MADE OCCUR
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY
PRO-
JECT LOC
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
CANCELLATION
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016/03)
© 1988-2016 ACORD CORPORATION. All rights reserved.
CERTIFICATE HOLDER
The ACORD name and logo are registered marks of ACORD
HIRED
AUTOS ONLY
1,000,000
272-1-05011/25
HOU-004170141-01
X
AGGREGATE
N
01/01/2025
TSDatabase@Mayo.edu
PROFESSIONAL LIABILITY
2,000,000
1,000,000
A
02/13/2025
4,000,000
01/01/2025
2,000,000
The State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, and employees as additional insureds with respect to liability arising out of the activities performed by or on behalf of the Insured.
X
Phoenix, AZ 85007
Arizona Department of Health Services
A
3733-MICL-Main-25-26
EACH CLAIM
1,000,000
50,000
01/01/2026
BY INSURED"
"COVERAGE INDEPENDENTLY PROCURED
d/b/a Mayo Clinic Laboratories
Mayo Collaborative Services, Inc.
272-1-05011/25
150 N. 18th Avenue, Suite 530
X
Certificate Requests
01/01/2026
Mayo Insurance Company Limited
Parker, Alfie Marsh V
File details come from the government source that posted it. Updated .